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Impact of Pharmacy Type on HIV Viral Suppression: A Retrospective Cross-Sectional Cohort Study

机译:药房类型对HIV病毒抑制的影响:回顾性横截面队列研究

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BackgroundPeople with HIV (PWH) use various pharmacy types beyond traditional local pharmacies. Some specialized pharmacies offer additive adherence services such as refill reminders, expedited delivery, and adherence packaging.MethodsThis single-center, retrospective cohort study evaluated the impact of pharmacy type on the gain or loss of HIV viral suppression (VS; HIV RNA?≤50 copies/mL). Patients (≥19 years) were categorized by VS and pharmacy type: HIV-specialized (additive adherence/delivery services) vs traditional (without adherence/delivery services). Fisher exact tests examined the effect of pharmacy type on differences in VS between years, and logistic regression models identified possible predictors of gaining or losing VS.ResultsDuring 2017–2018, no differences were observed for the gain or loss of VS across pharmacy types (VS gain vs continued viremia, P?=?.393; VS loss vs continued VS, P?=?.064). Predictors for the gain of VS included antiretroviral therapy adherence as percentage of days covered (PDC; adjusted odds ratio [aOR], 1.05; P??.001) and Federal Poverty Level 100%–138% (FPL; aOR, 0.17; P?=?.032). Predictors for the loss of VS included use of protease inhibitor (aOR, 2.85; P?=?.013), ≥1 other illicit substance including tobacco (aOR, 2.96; P?=?.024), PDC (aOR, 0.95; P??.001), FPL 139%–200% (aOR, 0.09; P?=?.031), and CD4?200 cells/ccm (aOR, 0.19; P?=?.013).ConclusionsThe gain or loss of VS among PWH in this retrospective cohort was not impacted by pharmacy transitions within the 2-year study period. However, PDC, FPL, illicit substance use, protease inhibitor use, and CD4?200 cells/ccm were identified as factors associated with changes in VS.
机译:Backgroundpeople与艾滋病毒(pwh)使用传统当地药房之外的各种药房类型。一些专业的药店提供添加剂遵守服务,如补充提醒,加急交付和遵守包装。近期的单中心,回顾性队列研究评估了药房类型对艾滋病病毒病毒抑制的增益或丧失的影响(Vs; HIV RNA?≤50副本/ ml)。患者(≥19岁)由VS和药物型分类:艾滋病毒专业(附加申请/送货服务)与传统(无粘附/送货服务)。 Fisher精确测试检测了药房类型对年之间VS差异的影响,并且逻辑回归模型确定了获得或失败的可能预测因子Vs.Resultsdring 2017-2018,在药房类型的增加或损失没有观察到差异(VS获得vs持续的病毒血症,p?=?393; vs损失与持续的vs,p?= 064)。 vs增益的预测因子包括抗逆转录病毒治疗依从性,作为覆盖的天数(PDC;调整后的赔率比[AOR],1.05; P?<β.001)和联邦贫困等级100%-138%(FPL; AOR,0.17; p?= 032)。 VS损失的预测因子包括蛋白酶抑制剂的使用(AOR,2.85; p?= 013),≥1其他非法物质,包括烟草(AOR,2.96; P?=β.024),PDC(AOR,0.95; p?<?001),FPL 139%-200%(AOR,0.09; p?= 031)和CD4?> 200个细胞/ CCM(AOR,0.19; P?=Δ.013)。CONCLUSIONSTHE GAIN在这次回顾性群组中,在本回顾性队列中的PWH中VS的损失不会受到2年期间的研究期内的药房转型。然而,PDC,FPL,非法物质使用,蛋白酶抑制剂使用和CD4?> 200个细胞/ CCM被鉴定为与VS的变化相关的因素。

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